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Early correction of the nose in unilateral cleft lip patients using an open method: a 10-year review
T Takato1, Y Yonehara, T Susami
1Department of Oral Surgery, Faculty of Medicine, University of Tokyo, Japan.
Purpose:
To review a 10-year follow-up of cases with rhinoplasty for a cleft lip-associated nose deformity done during the preschool years.
Materials And Methods:
Sixteen patients from 16 to 19 years of age were evaluated with two indices: the nasal index and the lobule portion of the columella index.
Results:
Several years after surgery the results appeared to be reasonably satisfactory. However, as the patients approached their adolescent growth spurt at 15 years of age, undesirable features became obvious. Each patient showed a strikingly bulbous nose. The nasal index of male patients ranged from 68.8% to 82.7% (mean, 75.4%) and that of female patients ranged from 72.7% to 85.0% (mean, 79.2%). The mean value of the nasal index in the Japanese male and female is 58.5% +/- 1.5% and 59.0% +/- 1.0%, respectively. The lobule portion index of male patients ranged from 57.1% to 72.0% (mean, 65.1%) and that of female patients ranged from 62.5% to 82.0% (mean, 74.2%). The lobule portion of the columella constitutes 33% of the total columellar length on average.
Conclusions:
A possible cause of the undesirable deformities is use of an open surgical method. A second possible cause is mobilization and suspension of the alar cartilages. These undesirable features may occur only in Oriental noses.